Epidemiological Characteristics and Swab-Based HPV Detection Method in HPV-Associated Head and Neck Papillomas: A Retrospective Study and Diagnosis Test.
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OBJECTIVES: Head and neck papillomas (HNPs) are benign yet frequently recurrent epithelial neoplasms caused by human papillomavirus (HPV). However, no accurate and convenient HPV detection method is widely adopted for these lesions. METHODS: We retrospectively analyzed 866 HNP patients (Nov 2008-Oct 2024) at West China Hospital. Epidemiological features were stratified by age and tumor site. Multivariate regression identified independent recurrence risk factors. A novel swab-based HPV test detecting 25 subtypes via capillary electrophoresis fragment analysis targeting HPV E6/E7 DNA was applied in 52 cases and compared with matched biopsy-based testing. RESULTS: Three clinically relevant findings were identified: (1) Pediatric HNPs showed a striking laryngeal predominance (89% vs 21% in adults), exclusive low-risk HPV infection (91% HPV-positive: 75% HPV11, 25% HPV6), and a 5-fold higher recurrence rate than adults. (2) HPV infection rates varied by anatomical site: highest in laryngeal (80.4%), followed by sinonasal (18.8%) and pharyngeal lesions (13.9%). Notably, all HPV-positive laryngeal lesions involved multiple subsites, while all HPV-negative laryngeal cases were limited to single subsites (mainly supraglottis). (3) HPV positivity was an independent predictor of poor outcomes, associated with significantly higher recurrence and more frequent surgeries. Additionally, the swab-based HPV test demonstrated high diagnostic performance (95% sensitivity, 100% specificity, AUC = 0.94), with 100% accuracy in detecting key genotypes (HPV6, 11, and 16). CONCLUSIONS: Our study reveals distinct age- and site-specific HPV infection patterns and highlights the prognostic impact of HPV status in HNPs. Most notably, we establish a novel, accurate, and practical swab-based HPV test as a promising tool for routine clinical management.